Identification of maternal characteristics associated with the use of epidural analgesia

ArticleinJournal of Obstetrics and Gynaecology 32(4):342-6 · May 2012with15 Reads
Impact Factor: 0.55 · DOI: 10.3109/01443615.2012.661491 · Source: PubMed
Abstract

The present survey aims to identify predictors associated with the use of epidural analgesia (EA). Therefore, from October 2007 to June 2008, a survey was conducted in 193 pregnant women (mean age 31.7 years (SD 4.9); 64.8% primipara) attending a German general hospital with a specialisation in integrative medicine. Questionnaires, including Antonovsky's sense of coherence (SOC) were delivered antepartum. Delivery data were recorded within the hospital quality management programme. The adjusted odds ratio (OR) for EA use was significantly greater than one for women who had previously used EA (adjusted OR =4.1; CI: 1.03-16.31) and for the desire for a delivery without pain (adjusted OR =3.05; CI: 1.36-6.83). The likelihood of EA use decreased in multipara (adjusted OR =0.05; CI: 0.01-0.22). SOC was not found to be an independent predictor for EA use. However, women with high SOC more often preferred a delivery without EA (p for trend =0.037). In conclusion, first time labour, the desire for a delivery without pain and previous use of EA are independent predictors for the use of EA in labour. Further studies should clarify the predictive role of SOC in pregnancy.

    • "...abour. Interestingly, actual epidural use was not found to be associated with SOC scores (Jeschke et al., 2012). These few studies examining relationships between women's SOC and their childbearing choices and ..."
      Another study of 193 pregnant German women found women with high SOC identified a desire to avoid epidural anaesthesia in labour. Interestingly, actual epidural use was not found to be associated with SOC scores (Jeschke et al., 2012). These few studies examining relationships between women's SOC and their childbearing choices and outcomes suggest that a woman's SOC may be associated with pregnancy choices and birthing outcomes although due to the small sample sizes of these studies, more research is required.
    Full-text · Article · Dec 2015 · Women and Birth
    0Comments 0Citations
    • "...abour. Interestingly, actual epidural use was not found to be associated with SOC scores (Jeschke et al., 2012). These few studies examining relationships between women's SOC and their childbearing choices and ..."
      Another study of 193 pregnant German women found women with high SOC identified a desire to avoid epidural anaesthesia in labour. Interestingly, actual epidural use was not found to be associated with SOC scores (Jeschke et al., 2012). These few studies examining relationships between women's SOC and their childbearing choices and outcomes suggest that a woman's SOC may be associated with pregnancy choices and birthing outcomes although due to the small sample sizes of these studies, more research is required.
    [Show abstract] [Hide abstract] ABSTRACT: Background: in Western countries, caesarean section rates are increasing at an alarming rate. This trend has implications for women׳s health and calls into question the use of pathogenesis to frame maternity services. The theory of salutogenesis offers an alternative as it focuses on health rather than illness. Sense of coherence (SOC), the cornerstone of salutogenesis, is a predictive indicator of health. This study aimed to explore associations between pregnant women׳s SOC, their birthing outcomes and factors associated with SOC changes. Methods: a longitudinal survey was conducted where women completed a questionnaire in the antenatal and postnatal period. Questionnaire one provided information on SOC scores, Edinburgh Postnatal Depression Scale (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. Questionnaire two provided information on SOC scores, EPDS scores and birthing outcomes. Findings: 1074 women completed questionnaire one and 753 women completed questionnaire two. Compared to women with low antenatal SOC, women with high antenatal SOC were less likely to experience caesarean section (OR 0.437 95% CI 0.209-0.915) and more likely to experience assisted vaginal birth (AVB) (OR 3.108 95% CI 1.557-6.203). Higher birth satisfaction, higher antenatal EPDS scores and lower antenatal SOC were associated with an increase in SOC. Epidural, AVB and decreased birth satisfaction were associated with a decrease in SOC. Conclusion: high sense of coherence in pregnant women is associated with half the likelihood of caesarean section compared to women with low sense of coherence. Women׳s sense of coherence is raised and lowered by degree of satisfaction with their births and lowered by some labour interventions.
    Full-text · Article · Dec 2015 · Midwifery
    0Comments 0Citations
    • "...004), parity (Sjostrom et al., 2004) or a desire to avoid epidural anaesthesia in labour (Jeschke et al., 2012). ..."
      Unlike Borrmann et al. (2002) this study found a pregnant woman's SOC was unrelated to planned place of birth with women with higher SOC scores being no more likely to plan a birth in a primary setting than women with lower SOC scores. Unlike other studies this study did not find that SOC was related to gestation (Sjostrom et al., 2004), parity (Sjostrom et al., 2004) or a desire to avoid epidural anaesthesia in labour (Jeschke et al., 2012).
    [Show abstract] [Hide abstract] ABSTRACT: as concern for increasing rates of caesarean section and interventions in childbirth in Western countries mounts, the utility of the risk approach (inherent in the biomedical model of maternity care) is called into question. The theory of salutogenesis offers an alternative as it focuses on the causes of health rather than the causes of illness. Sense of coherence (SOC), the cornerstone of salutogenic theory, is a predictive indicator of health. We hypothesised that there is a relationship between a woman׳s SOC and the childbirth choices she makes in pregnancy. the study aims to investigate the relationship between SOC and women׳s pregnancy and anticipated labour choices. A cross sectional survey was conducted where eligible women completed a questionnaire that provided information on SOC scores, Edinburgh Postnatal Depression (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. 1074 pregnant women completed the study. Compared to women with low SOC, women with high SOC were older, were less likely to identify pregnancy conditions, had lower EPDS scores and higher SBI scores. SOC was not associated with women׳s pregnancy choices. this study relates SOC to physical and emotional health in pregnancy as women with high SOC were less likely to identify pregnancy conditions, had less depressive symptoms and perceived higher levels of support compared to women with low SOC. Interestingly, SOC was not associated with pregnancy choices known to increase normal birth rates. More research is required to explore the relationship between SOC and women׳s birthing outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jul 2015 · Midwifery
    0Comments 3Citations
Show more